Chronic Obstructive Pulmonary Disease (COPD)

Asthma and chronic obstructive pulmonary disease (COPD) are two of the most common lung disorders in the United States. Differential diagnosis can be a challenge. According to the American Academy of Family Physicians guidelines on distinguishing asthma from COPD, asthma generally has earlier onset, more variable symptoms, and normal chest X-ray. Many options for diagnosis and treatment are available, including recently developed digital health tools.

Chronic obstructive pulmonary disorder (COPD) is a common lung disorder involving reduced airflow. Dexur has previously the relationship between air pollution and COPD in Oklahoma, a state with little air quality monitoring at county level. Connecticut, however, has monitors in each of its eight counties. Dexur has previously investigated length of stay among COPD patients in Connecticut. Here, analysts examined the relationship between air quality and 30-day COPD readmissions rate, a measure of disease burden

A Lancet Respiratory Medicine meta-analysis found that patients with chronic obstructive pulmonary disorder (COPD) have a 1.33 odds ratio of being diagnosed with hypertension, compared to the non-COPD population.

Chronic obstructive pulmonary disorder (COPD) is a common lung disease, mainly caused by smoking. There is evidence that COPD patients are at greater risk of mortality when exposed to air pollution, particularly particulate matter. Dexur analysts examined 2016 CMS inpatient discharge data from 20 Oklahoma hospitals with over 1,000 discharges that year. The incidence of COPD varied dramatically across hospitals, from 5.61% of total Medicare discharges at Jackson County Memorial Hospital to 0.54% at Mercy Hospital Oklahoma City.

Chronic obstructive pulmonary disease (COPD) is a lung disease involving reduced airflow. According to the Centers for Disease Control, COPD was the third-leading cause of death in the US in 2014. The main cause is long-term exposure to lung irritants. Dexur has covered COPD heavily, including the US hospitals with shortest length of stay.

Dexur analysts performed a correlational analysis on Michigan hospitals treating Medicare inpatients with COPD and found a moderate positive relationship between average index hospitalization LOS and readmission rate. This correlation can be evidenced by hospitals that have both low average index length of stay and low readmission rates, such as Oaklawn Hospital and St. Joseph Mercy Livingston Hospital. Oaklawn Hospital in Marshall had the state's lowest index LOS at just 2.81 days as well as the state's 2nd lowest readmission rate, seeing only 13.97% of COPD Medicare discharges had readmissions within 30 days. St. Joseph Mercy Livingston Hospital led the state with the lowest COPD readmission rate at just 11.4% and had the 5th lowest average LOS for the index hospital stay at 3.29 days.

Dexur analysts recently studied Medicare inpatient COPD discharges and found that Sharon Hospital in Sharon reported a 5.15 day average length of stay (LOS) for a 30-day episode of care with unplanned readmissions, the lowest rate in Connecticut. This was nearly a day lower than the national rate of 6.06 days and about a day and a half lower than the 6.49 day average for all Connecticut Medicare enrollees. UConn John Dempsey Hospital in Farmington ranked 2nd in the state at 5.24 days, while Middlesex Hospital in Middletown ranked 3rd at 5.41 days. These three hospitals were the only facilities in the state with a 30-day episode of care average LOS including unplanned readmissions below 5.5 days.

In September of 2017, GlaxoSmithKline and Innoviva, Inc. released Trelegy Ellipta, a once-daily inhaler therapy for chronic obstructive pulmonary disease (COPD). The inhaler triple-therapy is the first in the U.S. that combines three active molecules, fluticasone furoate (FF), umeclidinium (UMEC) and vilanterol (VI), in a single inhaler for the treatment of eligible COPD patients. FF is classified as an inhaled corticosteroid (ICS), VI is a long-acting β2 agonist (LABA) and UMEC is a long-acting muscarinic receptor antagonist (LAMA). Research from the Gold Initiative for Chronic Obstructive Lung Disease shows that the combination of an ICS, LABA, and LAMA is effective in treatment for group D COPD patients, a subset of patients with COPD who are more symptomatic and at higher risk for exacerbations. The combination of these three molecules in one product could be of further benefit as well, since patient compliance is boosted by the need to take fewer medications.

Based on a recent analysis performed by Dexur, two Baystate Health facilities were among the top five facilities in Massachusetts for lowest average length of stay (LOS) for a 30-day episode of care with unplanned readmissions. Baystate Mary Lane Hospital in Ware held the top spot with the lowest average LOS with unplanned readmissions at 3.45 days, while Baystate Franklin Medical Center in Greenfield averaged a 4.1 day LOS when including all COPD readmissions, the lowest in that category. Baystate Mary Lane Hospital also ranked 4th with all readmissions with an average LOS of 4.58 days. Baystate Franklin Medical Center ranked 3rd at 4.08 days for unplanned COPD readmissions. Dorchester’s Carney Hospital ranked 2nd in 30-day episode of care average LOS with unplanned readmissions at 3.8 days and with all readmissions at 4.36 days. The top five hospitals by average LOS for a 30-day episode of care including unplanned readmissions are shown in the graph below.